Saturday Quiz

Designed to Amaze and Enlighten!

 

How many risk-codes are included in your patient’s capitation calculation each year.

 

A. The top four based on revenue generated.

B. the four most common.

C. 4 for ages 65-74, 6 for ages 75 and above.

D. Depends on why they enrolled in Medicare in the first place.

E. None of the above.

 

The startling answer below:

X

x

x

x

x

x

x

x

x

x

x

x

x

x

x

 

The answer is E. None of the above.

There is no limit to the number of chronic conditions that can figure into the monthly capitation calculation of a Medicare Advantage recipient.  Some conditions cancel each other out, but there is no upper limit on the total.

My personal record is 17 in a patient with severe chronic illnesses who walked in off the street. Fortunately, s/he only needed my personal attention to set things right, but at first when he was very ill, I was well paid for my efforts.